Su Daniel, Stamatakis Lambros, Singer Eric A, Srinivasan Ramaprasad
aUrologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland bSection of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Curr Opin Oncol. 2014 May;26(3):321-7. doi: 10.1097/CCO.0000000000000069.
Renal cell carcinoma (RCC) continues to be the subject of vigorous clinical and translational investigation. Advances in systemic targeted therapies, new molecular pathways and immunotherapy approaches will be discussed.
Agents targeting the vascular endothelial growth factor (VEGF) and/or the mammalian target of rapamycin (mTOR) pathways continue to be the mainstay for treating metastatic RCC (mRCC). Although enhanced target specificity has improved the toxicity profile associated with newer VEGF-pathway antagonists, durable complete responses remain the exception. Identification of novel pathways/agents, as well as the optimal sequencing and combination of existing targeted agents, remain areas of active study. In addition, emerging data from early clinical trials have reinvigorated interest in immunomodulatory agents.
The therapeutic armamentarium available to genitourinary oncologists continues to grow, but much work remains to be done to fully realize the potential of pathway-specific targeted strategies and immune-based approaches for mRCC.
肾细胞癌（RCC）仍是临床和转化研究的热点。本文将讨论全身靶向治疗、新分子途径和免疫治疗方法的进展。
靶向血管内皮生长因子（VEGF）和/或哺乳动物雷帕霉素靶蛋白（mTOR）途径的药物仍然是治疗转移性肾细胞癌（mRCC）的主要手段。尽管增强的靶点特异性改善了与新型VEGF途径拮抗剂相关的毒性特征，但持久的完全缓解仍然少见。鉴定新的途径/药物，以及现有靶向药物的最佳序贯和联合使用，仍是积极研究的领域。此外，早期临床试验的新数据重新激发了人们对免疫调节剂的兴趣。
泌尿生殖系统肿瘤学家可用的治疗手段不断增加，但要充分实现针对mRCC的途径特异性靶向策略和基于免疫的方法的潜力，仍有许多工作要做。
